Pulmonary function and body composition parameters of children with cystic fibrosis from a hight complexity institution between 2015 and 2018.

BACKGROUND: An adequate nutritional status in patients with cystic fibrosis correlates with higher survival and better pulmonary function. Body mass index (BMI) is an anthropometric indicator with independent association with pulmonary function, and it can hide alterations of nutritional status in cystic fibrosis. OBJECTIVE: To determine the relationship of lung function with BMI and body composition parameters in children with cystic fibrosis in a Hight Complexity institution between 2015 and 2018. MATERIALS AND METHODS: It was an observational study with analytical, cross-sectional, and retrospective scope, including 33 patients between 5 and 17 years old. Spearman's test was applied to evaluate correlation of FEV1 (forced expiratory volume in first second) with BMI and five body composition parameters by bioelectrical impedance using InbodyS10 equipment. Statistical significance was considered with p < 0.05. RESULTS: Positive correlation was obtained between FEV1 and appendicular skeletal muscle mass between lung function and percentage of fat-free mass (p = 0.006) and phase angle (p = 0.001). Percent fat mass had a negative correlation with FEV1 (p = 0.007). BMI and fat free mass index did not correlate with lung function (p = 0.085). CONCLUSIONS: Appendicular skeletal muscle mass correlated better than BMI with lung function in children with cystic fibrosis. It is recommended to perform anthropometric follow-up by BMI complemented with body composition study in children with cystic fibrosis. Analyses with larger populations are required to standardize its use.

Ingesta de calcio y densidad mineral ósea en adolescentes chilenos con desarrollo puberal completo

Introducción: La cantidad diaria recomendada (RDA) de calcio en adolescentes es de 1.300 mg/día. La última Encuesta Nacional de Consumo Alimentario de Chile, mostró que la mediana de ingesta total de calcio fue menos de la mitad de la RDA. Una ingesta insuficiente de calcio puede impactar negativamente la mineralización ósea. Objetivo: Determinar el efecto de la ingesta de calcio y estado nutricional sobre la densidad mineral ósea (DMO) de adolescentes con desarrollo puberal completo. Métodos: Estudio de corte transversal. Participaron n= 79 adolescentes de ambos sexos de entre 17 y 18 años elegidos al azar, aparentemente sanos, estadio Tanner 5 e IMC-1 DE). Según estado nutricional, no hubo diferencias significativas en la ingesta de nutrientes, pero sí en la DMO. En media, la DMO estandarizada (puntaje Z) fue normal para ambos sexos (>-1 DE); los adolescentes con obesidad presentaron una DMO estandarizada significativamente mayor que los adolescentes de peso normal (1,05±0,85 vs 0.33±0,86; P= 0,04). La ingesta de calcio no se relacionó con la masa ósea total ni con la DMO estandarizada. Conclusión: En adolescentes con desarrollo puberal completo no hubo relación entre la ingesta de calcio y los niveles de mineralización ósea. Sí hubo relación entre mineralización ósea y estado nutricional, siendo mayor la DMO en los individuos con obesidad.

Background: In adolescents, the recommended daily intake (RDI) of calcium is 1,300 mg. In Chile, the latest National Survey of Food Consumption showed that the median total calcium intake was less than half of the RDI. An adequate intake of calcium in adolescence negatively affects BMD. Aim: To determine the association of calcium intake and nutritional status with bone mineral density (BMD) in male and female adolescents with completed pubertal development (Tanner 5). Methods: Cross-sectional study in a random sample of 79 male and female adolescents, ages 17-18. Participants were healthy, Tanner stage 5, and BMI −1 SD. BMD was higher in obese participants compared to normal-weight adolescents (1.05±0.85 vs 0.33±0.86; P= 0.04), although no differences in nutrients and food intake. Calcium intake was unrelated to total bone mass and unstandardized BMD. Conclusions: In our sample of adolescents with complete pubertal development, there was no relationship between calcium intake and bone mineralization levels. There was a significant relationship between bone mineralization and nutritional status, with BMD being higher in adolescents with obesity.

Alimentación en tiempo restringido: Efectos cardiometabólicos en adultos con exceso de peso

En individuos con malnutrición por exceso, tanto la resistencia a la insulina como la hipertensión arterial se asocian al desarrollo de enfermedades cardiovasculares y un mayor riesgo de mortalidad. Desde el punto de vista nutricional, la alimentación en tiempo restringido (ATR) emerge como una intervención dietoterapéutica que puede contribuir a contrarrestar las consecuencias de la malnutrición por exceso. La siguiente revisión describe el efecto de la aplicación de la ATR sobre la resistencia a la insulina y presión arterial elevada. Finalmente, se abordan otros factores que subyacen a los efectos cardiometabólicos y consideraciones prácticas.

In obesity, insulin resistance and arterial hypertension are associated with the development of cardiovascular diseases and increased mortality risk. Time Restricted Feeding (TRF) has emerged as a dietary intervention that can help counteract the consequences of obesity. In the present review, we analyze TRF effects and its application on insulin resistance and high blood pressure. Finally, we discuss other factors underlying cardiometabolic effects and provide practical considerations.

Predictive equations are inaccurate to assess caloric needs in non-white adults from Chile.

OBJECTIVES: Predictive equations are frequently used to estimate resting energy expenditure (REE) because indirect calorimetry (IC) is not always available and is expensive. The aim of this study was to determine the concordance between the estimation of REE using predictive equations and its measurement by IC. METHODS: This was an analysis of the registry of indirect calorimetry performed in non-hospitalized participants. Harris-Benedict, FAO/WHO/UNU, Mifflin St. Jeor, and European Society for Clinical Nutrition and Metabolism (ESPEN) equations were used to estimate REE in these individuals. The concordance between measured and estimated REE using real, ideal, and adjusted weight was calculated using the concordance coefficient analysis of Lin and Bland- Altman plots in all participants and in subgroups separated according to their body mass index. RESULTS: We retrieved 680 measurements and discarded 247 that did not comply with the inclusion criteria. Thus, we studied 433 participants ages 36 y (29-48 y). Of the participants, 341 were women (79%) and the participants had a body mass index (BMI) of 30 kg/m2 (26.7-33.1 kg/m2). All predictive equations had concordance values <0.90. The proportion of participants in which the difference was >10% ranged from 36% to 87%. The ESPEN equation had the greater proportion of erroneous estimations of REE in all participants and BMI subgroups when real weight was used. CONCLUSIONS: We observed a low level of concordance between REE estimated using predictive equations and measured by IC. These results should alert clinicians about the inaccuracy of predictive equations.

Sarcopenia and frailty in older adults hospitalized in internal medicine wards / Sarcopenia y fragilidad en adultos mayores hospitalizados en salas medicina interna

Abstract Introduction: sarcopenia and frailty are mutual risk clinical syndromes and adverse outcome indicators. There are currently no data in Latin America regarding the prevalence of these conditions in hospitalized patients. Objective: to determine the prevalence and clinical characteristics of patients age 65 and older with sarcopenia in internal medicine wards. Materials and methods: an observational, descriptive, prospective cross-sectional study, including men and women age 65 and older. The EWGSOP (European Working Group on Sarcopenia in Older People) and PRISMA 7 criteria were applied to determine sarcopenia and frailty, respectively. Results: out of 124 patients, 41.13% had sarcopenia, 34.68% had frailty and 18.55% had both. The median age was 74; 50.8% were women and 49.2% men. Conclusion: sarcopenia and frailty are highly prevalent in our population, with higher figures than those reported in the available literature. Subsequent studies may determine the effect of these conditions on clinical outcomes and costs. (Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1242)

Resumen Introducción: la sarcopenia y la fragilidad son síndromes clínicos de riesgo mutuo e indicadores de desenlaces adversos. Actualmente no hay datos en Latinoamérica sobre la prevalencia de estas condiciones en pacientes hospitalizados. Objetivo: determinar la prevalencia y características clínicas de los pacientes de 65 años o más con sarcopenia en salas de medicina interna. Material y métodos: estudio observacional, descriptivo, prospectivo, transversal. Incluyó hombres y mujeres de 65 años o más. Se aplicaron criterios de la EWGSOP (European Working Group on Sarcopenia in Older People) y PRISMA 7 para la determinación de sarcopenia y fragilidad respectivamente. Resultados: de 124 pacientes, 41.13% tenían sarcopenia, 34.68% fragilidad y las dos condiciones 18.55%. La mediana de edad fue 74 años, 50.8% mujeres y 49.2% hombres. Conclusión: la sarcopenia y la fragilidad tienen una alta prevalencia en nuestra población, cifras superiores a las reportadas en la literatura disponible. Estudios posteriores podrán determinar el efecto de estas condiciones en desenlaces clínicos y costos. (Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1242).

Effect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing age.

INTRODUCTION: Micronutrient deficiencies are one of the most important public health issues worldwide and iron (Fe) deficiency anemia is the most prevalent micronutrient deficiency. Iron deficiency often coexists with calcium deficiency and iron and calcium supplementation often overlap. This has led to investigations into the interaction between these two minerals, and whether calcium may inhibit iron absorption in the gut. OBJECTIVE: To determine the effect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing age. METHODS: A randomized and single blinded trial was conducted on 27 women of childbearing age (35-45 years old) divided into 2 groups (n1 = 13 and n2 = 14, respectively). On four different days, after an overnight fast, they received 5 mg of Fe as FeSO4 (labeled with 55Fe or 59Fe) with 800 mg of elemental calcium in the form of either calcium chloride, calcium gluconate, calcium citrate, calcium carbonate, calcium lactate, calcium sulfate or calcium phosphate. Calcium chloride was used as the control salt in both groups. Iron was labeled with the radioisotopes 59Fe or 55Fe, and the absorption of iron was measured by erythrocyte incorporation of radioactive Fe RESULTS: 800 mg of elemental calcium as calcium citrate produced a significant decrease in non-heme iron bioavailability (repeated measures ANOVA, F = 3.79, p = 0.018). CONCLUSION: Of the various calcium salts tested, calcium citrate was the only salt that decreased non-heme iron bioavailability relative to the calcium chloride control when taken on an empty stomach. These results suggest that inhibition of non-heme iron absorption in fasted individuals is dependent upon the calcium salt in question and not solely dependent on the presence of calcium.